Mental illness is a term that describes a broad range of mental and emotional conditions. Mental illness also refers to one portion of the broader ADA term mental impairment, and is different from other covered mental impairments such as mental retardation, organic brain damage, and learning disabilities. The term µpsychiatric disability¶ is used when mental illness significantly interferes with the performance of major life activities, such as learning, working and communicating, among others. The most common forms of mental illness are anxiety disorders, mood disorders, and schizophrenia disorders. Brief introductory information about these conditions is presented in this section for educational purposes only.
Anxiety disorders, the most common group of mental illnesses, are characterized by severe fear or anxiety associated with particular objects and situations.
Mood disorders are also known as affective disorders or depressive disorders. These illnesses share disturbances or changes in mood, usually involving either depression or mania (elation). With appropriate treatment, more than 80% of people with depressive disorders improve substantially.
Research has not yet determined whether schizophrenia is a single disorder or a group of related illnesses. The illness is highly complex, and few generalizations hold true for all people diagnosed with schizophrenia disorders. However, most people initially develop the symptoms between the ages of 15 and 25. Typically, the illness is characterized by thoughts that seem fragmented and difficulty processing information. Symptoms of schizophrenia disorders are categorized as either "negative" or "positive." Negative symptoms include social isolation or withdrawal, loss of motivation, and a flat or inappropriate affect (mood or disposition). Positive symptoms include hallucinations, delusions, and thought disorders.
*Adapted from Zuckerman, D., Debenham, K. & Moore, K. (1993) The ADA and People with Mental Illness: A Resource Manual for Employers. Available from the National Mental Health Association, 1021 Prince Street, Alexandria, VA 22314-2971, (703)684-7722 (703)684-7722 .
³English´ Examples of Disclosing a Mental Illness
The Equal Employment Opportunity Commission (EEOC) has published new Enforcement Guidance on the ADA and People with Mental Illness. In it, the EEOC states that someone who
has a mental illness can tell their employer about the illness using ³ English´. This means that the employee is not required to use certain terms such as clinical diagnoses, mental illness or psychiatric disability to disclose mental illness and request accommodations. Some examples of the terms and phrases that an employer may hear are:
y y y
I have a medical condition that requires more frequent breaks to do my work. I need some time off /a leave of absence because I am stressed and depressed. I take medication for a disorder that makes it difficult to get up early in the morning.
Characteristics of Psychiatric Disability that Affect Functioning
The irregular nature of mental illness - The irregular nature of mental illness may create problems in establishing or maintaining consistent work or school patterns. Some individuals may need time off for medical appointments or to recuperate. The irregular nature of mental illness might also impair an individual's performance. Stress associated with non-disclosure - Anxiety often accompanies the effort to hide an illness and its symptoms. Many individuals do not disclose an illness for fear of stigma and discrimination. This fear may be compounded if an employee feels that a job is in jeopardy or a student worries that admission may not be offered. Side effects of medications - Despite their effectiveness for many people, medications can also have side effects that create difficulties at work or in school. Each person has an adjustment period after starting, changing the dose of, or stopping medication. Some of the most common side effects include: o drowsiness o dizziness o dry mouth o nervousness o headaches o shakiness o confusion o weight gain Interrupted education or training - Many people first develop symptoms of mental illnesses between the ages of 15 and 25 and traditional educational or vocational training may be delayed. This may affect their credentials for jobs or educational programs. Co-morbidity - The National Institute of Mental Health (NIMH) reports that 30% of adults with a mental illness also have had a diagnosable alcohol and/or drug abuse disorder during their lives. In addition, 53% of adults who have had substance abuse disorders have had one or more mental illnesses during their life times. Treatment and accommodation in these cases address both the effects of substance abuse as well as the effects of the person's mental illness.